Incidence of Serum Creatinine Monitoring and Outpatient Visit Follow-Up among Acute Kidney Injury Survivors after Discharge: A Population-Based Cohort Study

2021 ◽  
pp. 1-10
Author(s):  
Erin F. Barreto ◽  
Diana J. Schreier ◽  
Heather P. May ◽  
Kristin C. Mara ◽  
Alanna M. Chamberlain ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Cohort Study ◽  
Serum Creatinine ◽  
Kidney Injury ◽  
Population Based ◽  
Post Discharge ◽  
Comorbidity Burden ◽  
Function Testing ◽  
Healthcare Visit

<b><i>Introduction:</i></b> Acute kidney injury (AKI) affects 20% of hospitalized patients and worsens outcomes. To limit complications, post-discharge follow-up and kidney function testing are advised. The objective of this study was to evaluate the frequency of follow-up after discharge among AKI survivors. <b><i>Methods:</i></b> This was a population-based cohort study of adult Olmsted County residents hospitalized with an episode of stage II or III AKI between 2006 and 2014. Those dismissed from the hospital on dialysis, hospice, or who died within 30 days after discharge were excluded. The frequency and predictors of follow-up, defined as an outpatient serum creatinine (SCr) level or an in-person healthcare visit after discharge were described. <b><i>Results:</i></b> In the 627 included AKI survivors, the 30-day cumulative incidence of a follow-up outpatient SCr was 80% (95% confidence interval [CI]: 76% and 83%), a healthcare visit was 82% (95% CI: 79 and 85%), or both was 70% (95% CI: 66 and 73%). At 90 days and 1 year after discharge, the cumulative incidences of meeting both follow-up criteria rose to 82 and 91%, respectively. Independent predictors of receiving both an outpatient SCr assessment and healthcare visit within 30 days included lower estimated glomerular filtration rate at discharge, higher comorbidity burden, longer length of hospitalization, and greater maximum AKI severity. Age, sex, race/ethnicity, education level, and socioeconomic status did not predict follow-up. <b><i>Conclusions:</i></b> Among patients with moderate to severe AKI, 30% did not have follow-up with a SCr and healthcare visit in the 30-day post-discharge interval. Follow-up was associated with higher acuity of illness rather than demographic or socioeconomic factors.

scholarly journals Defining Baseline Creatinine for Identification of Acute Kidney Injury in Population-based Laboratory Databases - A Danish Nationwide Cohort Study

Kidney360 ◽  
2021 ◽  
pp. 10.34067/KID.0006082021
Author(s):  
Henriette V. Graversen ◽  
Simon K. Jensen ◽  
Søren V. Vestergaard ◽  
Uffe Heide-Jorgensen ◽  
Christian F. Christiansen
Keyword(s):  
Acute Kidney Injury ◽  
Cohort Study ◽  
Creatinine Level ◽  
Kidney Injury ◽  
Population Based ◽  
Kaplan Meier ◽  
All Cause Mortality ◽  
Baseline Creatinine ◽  
Creatinine Measurement

Background: The baseline creatinine level is central in the KDIGO criteria of acute kidney injury (AKI), but baseline creatinine is often inconsistently defined or unavailable in AKI research. We examined the rate, characteristics, and 30-day mortality of AKI in five AKI cohorts created using different definitions of baseline creatinine. Methods: This nationwide cohort study included all individuals aged ≥18 in Denmark with a creatinine measurement in year 2017. Applying the KDIGO criteria, we created four AKI cohorts using four different baseline definitions (most recent, mean, or median value of outpatient creatinine 365-8 days before, or median value 90-8 days before if available otherwise median value 365-91 days before) and one AKI cohort not using a baseline value. AKI rate and the distribution of age, sex, baseline creatinine, and comorbidity was described for each AKI cohort, and the 30-day all-cause mortality was estimated using the Kaplan-Meier method. Results: The study included 2,095,850 adults with at least one creatinine measurement in 2017. The four different baseline definitions identified between 61,189 and 62,597 AKI episodes. The AKI rate in these four cohorts was 13-14 per 1,000 person-years, and 30-day all-cause mortality was 17-18%. The cohort created without using a baseline creatinine included 37,659 AKI episodes, corresponding to an AKI rate of 8.2 per 1,000 person-years, and a 30-day mortality of 23%. All five cohorts were similar regarding age, sex, and comorbidity. Conclusions: In a population-based setting with available outpatient baseline creatinine, different baseline creatinine definitions revealed comparable AKI cohorts, while the lack of a baseline creatinine when defining AKI led to a smaller AKI cohort with a higher mortality. These findings underscore the importance of availability and consistent use of an outpatient baseline creatinine, in particular in studies of community-acquired AKI.

scholarly journals Renin–angiotensin system blocker use and the risk of acute kidney injury after colorectal cancer surgery: a population-based cohort study

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e032964
Author(s):  
Charlotte Slagelse ◽  
H Gammelager ◽  
Lene Hjerrild Iversen ◽  
Kathleen D Liu ◽  
Henrik T Toft Sørensen ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Acute Kidney Injury ◽  
Cohort Study ◽  
Angiotensin Receptor Blockers ◽  
Kidney Injury ◽  
Population Based ◽  
Adjusted Risk ◽  
Increased Risk ◽  
The Impact ◽  
Postoperative Aki

ObjectivesIt is unknown whether preoperative use of ACE inhibitors (ACE-I) or angiotensin receptor blockers (ARBs) affects the risk of acute kidney injury (AKI) after colorectal cancer (CRC) surgery. We assessed the impact of preoperative ACE-I/ARB use on risk of AKI after CRC surgery.DesignObservational cohort study. Patients were divided into three exposure groups—current, former and non-users—through reimbursed prescriptions within 365 days before the surgery. AKI within 7 days after surgery was defined according to the current Kidney Disease Improving Global Outcome consensus criteria.SettingPopulation-based Danish medical databases.ParticipantsA total of 9932 patients undergoing incident CRC surgery during 2005–2014 in northern Denmark were included through the Danish Colorectal Cancer Group Database.Outcome measureWe computed cumulative incidence proportions (risk) of AKI with 95% CIs for current, former and non-users of ACE-I/ARB, including death as a competing risk. We compared current and former users with non-users by computing adjusted risk ratios (aRRs) using log-binomial regression adjusted for demographics, comorbidities and CRC-related characteristics. We stratified the analyses of ACE-I/ARB users to address any difference in impact within relevant subgroups.ResultsTwenty-one per cent were ACE-I/ARB current users, 6.4% former users and 72.3% non-users. The 7-day postoperative AKI risk for current, former and non-users was 26.4% (95% CI 24.6% to 28.3%), 25.2% (21.9% to 28.6%) and 17.8% (17.0% to 18.7%), respectively. The aRRs of AKI were 1.20 (1.09 to 1.32) and 1.16 (1.01 to 1.34) for current and former users, compared with non-users. The relative risk of AKI in current compared with non-users was consistent in all subgroups, except for higher aRR in patients with a history of hypertension.ConclusionsBeing a current or former user of ACE-I/ARBs is associated with an increased risk of postoperative AKI compared with non-users. Although it may not be a drug effect, users of ACE-I/ARBs should be considered a risk group for postoperative AKI.

Paucity of renal follow-up by school age after neonatal cardiac surgery

2020 ◽  
Vol 30 (6) ◽  
pp. 822-828
Author(s):  
Sara Rodriguez-Lopez ◽  
Louis Huynh ◽  
Kelly Benisty ◽  
Adrian Dancea ◽  
Daniel Garros ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Cardiac Surgery ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Kidney Injury ◽  
Post Discharge ◽  
Heart Repair ◽  
Neonatal Cardiac Surgery

AbstractIntroduction:There are little data about renal follow-up of neonates after cardiovascular surgery and no guidelines for long-term renal follow-up. Our objectives were to assess renal function follow-up practice after neonatal cardiac surgery, evaluate factors that predict follow-up serum creatinine measurements including acute kidney injury following surgery, and evaluate the estimated glomerular filtration rate during follow-up using routinely collected laboratory values.Methods:Two-centre retrospective cohort study of children 5–7 years of age with a history of neonatal cardiac surgery. Univariable and multivariable analyses were performed to determine factors associated with post-discharge creatinine measurements. Glomerular filtration rate was estimated for each creatinine using a height-independent equation.Results:Seventeen of 55 children (30%) did not have any creatinine measured following discharge after surgery until the end of study follow-up, which occurred at a median time of 6 years after discharge. Of the 38 children who had the kidney function checked, 15 (40%) had all of their creatinine drawn only in the context of a hospitalisation or emergency department visit. Acute kidney injury following surgery did not predict the presence of follow-up creatinine measurements.Conclusions:A large proportion of neonates undergoing congenital heart repair did not have a follow-up creatinine measured in the first years following surgery. In those that did have a creatinine measured, there did not appear to be any identified pattern of follow-up. A follow-up system for children who are discharged from cardiac surgery is needed to identify children with or at risk of chronic kidney disease.

scholarly journals Proton pump inhibitors and the risk of acute kidney injury in older patients: a population-based cohort study

CMAJ Open ◽  
2015 ◽  
Vol 3 (2) ◽  
pp. E166-E171 ◽  
Author(s):  
T. Antoniou ◽  
E. M. Macdonald ◽  
S. Hollands ◽  
T. Gomes ◽  
M. M. Mamdani ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Cohort Study ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Older Patients ◽  
Kidney Injury ◽  
Population Based

scholarly journals Risk of developing severe sepsis after acute kidney injury: a population-based cohort study

Critical Care ◽  
2013 ◽  
Vol 17 (5) ◽  
pp. R231 ◽  
Author(s):  
Tai-Shuan Lai ◽  
Cheng-Yi Wang ◽  
Sung-Ching Pan ◽  
Tao-Min Huang ◽  
Meng-Chun Lin ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Severe Sepsis ◽  
Cohort Study ◽  
Kidney Injury ◽  
Population Based

Incidence of acute kidney injury in cancer patients: A Danish population-based cohort study

2011 ◽  
Vol 22 (4) ◽  
pp. 399-406 ◽  
Author(s):  
Christian Fynbo Christiansen ◽  
Martin Berg Johansen ◽  
Wendy J. Langeberg ◽  
Jon P. Fryzek ◽  
Henrik Toft Sørensen
Keyword(s):  
Acute Kidney Injury ◽  
Cohort Study ◽  
Cancer Patients ◽  
Kidney Injury ◽  
Population Based ◽  
Danish Population

Follow-up of Acute kidney injury in Neonates during Childhood Years (FANCY): a prospective cohort study

2017 ◽  
Vol 32 (6) ◽  
pp. 1067-1076 ◽  
Author(s):  
Matthew W. Harer ◽  
Chelsea F. Pope ◽  
Mark R. Conaway ◽  
Jennifer R. Charlton
Keyword(s):  
Acute Kidney Injury ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Kidney Injury

scholarly journals Nonapnea Sleep Disorders and the Risk of Acute Kidney Injury: A Population-based Retrospective Cohort Study

2015 ◽  
Vol 17 (2) ◽  
pp. S22
Author(s):  
Hugo You-Hsien Lin ◽  
Kai-Ting Chang ◽  
Yu-Han Chang ◽  
Chi-Chih Hung ◽  
Hung-Chun Chen ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Cohort Study ◽  
Sleep Disorders ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Kidney Injury ◽  
Population Based

scholarly journals Cystatin C- an early marker indicative of renal dysfunction in critically ill children: a prospective cohort study

2019 ◽  
Vol 6 (5) ◽  
pp. 1981
Author(s):  
Hawwa M.S. Siddiqua ◽  
Mathew John ◽  
V. C. Manoj ◽  
Rati Santhakumar
Keyword(s):  
Acute Kidney Injury ◽  
Cohort Study ◽  
Serum Creatinine ◽  
Renal Dysfunction ◽  
Critically Ill ◽  
Cystatin C ◽  
Prospective Cohort ◽  
Kidney Injury ◽  
Critically Ill Children ◽  
Serum And Urine

Background: Acute kidney injury (AKI) is a sudden onset of kidney failure or kidney damage that happens within a few hours or a few days and can also affect other organs such as brain, heart and the lungs. Hence early diagnosis and intervention is needed to improve the outcome of the children. In these studies this objective was to determine if cystatin C is an early marker indicative of renal dysfunction in critically ill children and to determine if Cystatin C can detect Acute kidney injury earlier than serum creatinine.Methods: This prospective cohort study was undertaken in PICU at Jubilee Mission Medical College from December 2016- May 2018. Blood samples were collected from 34 critically ill children for serum creatinine estimation at 0,24 and 48 hours of admission and serum and urine were collected for cystatin C estimation at admission. Children were categorized into AKI and NON-AKI based on pRIFLE criteria. Comparison of cystatin C values with serum creatinine was performed and Statistical analysis was done using IBM SPSS version 20.Results: A total of 34 critically ill children were enrolled in this study, out of which 12 children progressed to AKI during the course of illness according to modified Pediatric Risk, Injury, Failure, Loss, End Stage Renal Disease (pRIFLE) criteria. We found a strong positive correlation between cystatin C at 0 hours and serum creatinine at 48 hours among AKI groups.Conclusions: Serum and Urine cystatin C are early markers to diagnose AKI in critically ill children. Serum cystatin C is more sensitive than urine cystatin C for the diagnosis of AKI.

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